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A review of dexamethasone as an adjunct to adenotonsillectomy in the pediatric population

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Abstract

Although one of the most commonly performed surgical procedures in children and frequently performed as outpatient surgery, the postoperative course following tonsillectomy may include nausea, vomiting, poor oral intake, and pain. These problems may last days into the postoperative course. Although opioids may be used to treat the pain, comorbid conditions such as obstructive sleep apnea may mandate limiting the dose and the frequency of administration. Adjunctive agents may improve the overall postoperative course of patients and limit the need for opioid analgesics. Dexamethasone is a frequently administered intraoperatively as an adjunctive agent to decrease inflammation and pain, limit the potential for postoperative nausea and vomiting, and improve the overall postoperative course. The following manuscript reviews the use of dexamethasone to improve outcomes following tonsillectomy or adenotonsillectomy, discusses the controversies regarding its potential association with perioperative bleeding, and investigates options for dosing regimens which may maintain the beneficial physiologic effects while limiting the potential for bleeding.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Royal Hospital for Children, Glasgow, UK

    Adele King

  2. Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Adele King & Joseph D. Tobias

  3. Department of Otolaryngology and Head & Neck Surgery, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA

    Charles Elmaraghy & Meredith Lind

  4. Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA

    Joseph D. Tobias

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  1. Adele King
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  2. Charles Elmaraghy
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  4. Joseph D. Tobias
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Correspondence to Joseph D. Tobias.

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King, A., Elmaraghy, C., Lind, M. et al. A review of dexamethasone as an adjunct to adenotonsillectomy in the pediatric population. J Anesth 34, 445–452 (2020). https://doi.org/10.1007/s00540-020-02758-y

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  • DOI: https://doi.org/10.1007/s00540-020-02758-y

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